There are both epidural benefits and risks that should be considered before you make your choice when you give birth. According to The American Pregnancy Association, epidural anesthesia is used by more than half of the women who give birth at a hospital. And, when it comes to getting relief from pain while in labor, this is considered the most popular of all of the methods available.

More than any other pain relief option, epidurals are requested the most by women who are getting ready to deliver their baby. Despite their popularity, however, it is important to be aware of epidurals benefits and risks before you decide if this is the path that you would like to take when you go into labor.

What are the pros and cons of epidurals, and what are some of the most important things that you should consider as you weigh your pain relief options? Check out the information below to learn more about epidurals benefits and risks.

Epidurals Benefits and Risks: What You Need to Know

1. Epidurals aren’t always totally safe

Many women today are under the impression that epidurals are perfectly safe with no risks or side effects on mom or babies, and there are many providers out there who will not take the time to help educate mothers to the contrary. So I thought I would put together a post about epidurals and the risks and benefits for mothers and their babies.

Now before I start, I just want to get it out there that with both of my children, I had an epidural. The first time I was not aware of any of the risks or side effects, and the second time I labored naturally for around 24 hours before getting the epidural to help allow me to sleep. Being a benefit to me. I needed to “re charge” so I could again focus on what was important and that was getting my baby here. Unfortunately the experience ended in a cesarean section, but I did not have to go through getting an epidural, waiting for it to work, and then possibly having it not work once we were in the operating room.

If I could do it all over again, I wouldn’t have had an epidural either time, but third time is a charm right?

2. According to the website for the American Pregnancy Association, some of the epidural anesthesia benefits include:

  • Allows for rest in prolonged labored (As was my case)
  • Relieving the discomfort of childbirth can help some woman have a more positive birth experience
  • When other types of coping mechanisms are not helping any longer, an epidural may be what you need to move through exhaustion, irritability, and fatigue. An epidural may allow you to rest, relax, get focused and give you the strength to move forward as an active participant in your birth experience.
  • If you deliver by cesarean, an epidural anesthesia will allow you to stay awake and also provide effective pain relief during recovery
  • In most cases, when using epidural anesthesia compared to other types of pain relief, you will remain more alert and aware of what is going on.

3. But, like everything in life, there are epidural risks!

According to the website for the American Pregnancy Association, some of the risks of epidural anesthesia include:

  • Epidurals may cause your blood pressure to suddenly drop. For this reason your blood pressure will be routinely checked to make sure there is adequate blood flow to your baby. If this happens you may need to be treated with IV fluids, medications, and oxygen.
  • You may experience a severe headache caused by leakage of spinal fluid. Less than 1% of women experience this side effect from epidural use. If symptoms persist, a special procedure called a “blood patch”, an injection of your blood into the epidural space, can be done to relieve the headache.
  • After your epidural is placed, you will need to alternate from lying on one side to the other in bed and have continuous monitoring for changes in fetal heart rate. Lying in one position can sometimes cause labor to slow down or stop.

4. You may experience the following side effects:

  • Shivering
  • Ringing of the ears
  • Backache
  • Soreness where the needle is inserted
  • Nausea
  • Difficulty urinating

5. It might result in the need for other interventions

Another thing to think about as you evaluate epidurals benefits and risks is that you may find that your epidural makes pushing more difficult, and additional interventions, such as Pitocin, forceps, vacuum extraction, or cesarean may become necessary.

6. What happens after the epidural is worth thinking about, too

  • For a few hours after birth, the lower half of your body may feel numb, which will require you to walk with assistance.
  • In rare instances, permanent nerve damage may result in the area where the catheter was inserted.
  • Though research is somewhat ambiguous, most studies suggest some babies will have trouble “latching on,” which can lead to breastfeeding difficulties.
  • Other studies suggest that the baby may experience respiratory depression, fetal malpositioning; and an increase in fetal heart rate variability, which may increase the need for forceps, vacuum, cesarean deliveries and episiotomies.

There are also some things that their website does not touch on, such as the increased risk of cesarean section due to stalled labor, or epidurals causing labors to become prolonged.

The problem with this is, today in most hospitals there are strict time limits on the amount of hours a woman can labor. If you exceed, 12, 18, or even 24 hours in some cases, you are looking at a vacuum assisted delivery or even a cesarean section for something that has become very common called “failure to progress” which is what lead to my first cesarean section, after a short 6 hours in labor. Yup, you heard it folks, I was induced for 6 hours before being wheeled off to the operating room.

7. Some of the other commonly untold risks, taken from Kim James Website, birth doula, include:

  • Prolonged 1st stage of labor
  • Increase of malpresentation of baby’s head
  • Increase in the need for pitocin augmentation
  • Prolonged 2nd stage of labor
  • Decrease in the ability to push effectively.
  • Increased likelihood of an episiotomy
  • Increase in cesarean section delivery (50% Increase at 2cm, 33% Increase at 3cm, 26% Increase at 4cm, After 5cm there was no difference)
  • Urinary Retention that can lead to postpartum bladder dysfunction
  • Hypotension (drop in blood pressure as earlier stated)
  • Itching of the face, neck and throat
  • Postpartum headaches (which I experienced very badly after the birth of my second child. I could not leave my bedroom with the curtains drawn without my head pounding uncontrollably.)
  • Maternal Fever (Sometimes blamed on the woman’s waters being broken too long instead of the epidural itself)
  • Feeling of emotional detachment
  • Inability to move freely on your own

8. Finally, we cannot forget the risks to your baby, which include:

  • Fetal Distress also known as an abnormal fetal heart rate
  • Drowsiness at birth
  • Poor sucking reflex due to the anesthesia (which can directly impact breastfeeding)
  • Poor muscle tone or strength in the first hours of life
  • Low Apgar scores

9. Epidurals aren’t always safe to administer

When you evaluate epidurals benefits and risks, it is also important to realize that an epidural might not even be an option in certain cases. For example if you are currently taking blood thinners, an epidural likely will not be an appropriate option for pain relief while you are in labor. Also, if you have been diagnosed with a blood infection, or an infection in or on your back, an epidural might not be safe for you to use.

Other scenarios in which it would be best to avoid the use of an epidural during labor include:

  • If you have been diagnosed with low platelet counts
  • If you are in shock
  • If you are hemorrhaging
  • If the physician is having difficulty locating the epidural space
  • If your labor is progressing too quickly, as this would mean that there isn’t enough time to give you the epidural

Note, too, that you need to be at least 4 cm dilated to get an epidural, so if you are not dilated enough, your doctor will likely tell you that you will need to consider other pain relieving options.

Be Sure to Educate Yourself on Epidurals Benefits and Risks

As you can see, there are many epidurals benefits and risks to think about as you prepare to welcome your baby to the world. Be sure to become educated yourself before consenting to any kind of medical intervention during labor, you may not get all of the information that is available to you!

Information for this blog have come from the following websites:

American Pregnancy Association
Medical Risks of Epidurals

Kim James